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已发表论文
早产儿中重度支气管肺发育不良脐带血中 CD40L 和 NGAL 水平分析及其临床价值：单中心回顾性研究
Authors Li W, Guo X, He X, Ma H, Li Y, Fu L, Qie X
Received 17 April 2025
Accepted for publication 20 August 2025
Published 8 October 2025 Volume 2025:16 Pages 279—288
DOI https://doi.org/10.2147/PHMT.S535128
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Professor Roosy Aulakh
Weina Li,1 Xiuya Guo,1 Xian He,1 Huanhuan Ma,1 Yan Li,2 Linlin Fu,2 Xuemin Qie1
1Department of Neonatology, Baoding Maternal and Child Health Care Hospital, Baoding, Hebei, People’s Republic of China; 2Department of Pediatrics, Baoding Maternal and Child Health Care Hospital, Baoding, Hebei, People’s Republic of China
Correspondence: Xuemin Qie, Department of Neonatology, Baoding Maternal and Child Health Care Hospital, Baoding, Hebei, People’s Republic of China, Email QieXueminxx88@163.com
Objective: To examine the concentrations of cluster of differentiation CD40 ligand (CD40L) and neutrophil gelatinase-associated lipocalin (NGAL) in preterm infants with moderate to severe bronchopulmonary dysplasia (BPD), as well as to elucidate their clinical implications.
Methods: A cohort of 138 preterm infants admitted to the neonatal intensive care unit between January 2021 and October 2022 were enrolled and divided into two groups: moderate to severe BPD (n=14) and non-BPD controls (n=124). Clinical data were collected. CD40L and NGAL levels in umbilical cord blood were measured by ELISA. Pearson correlation analysis and multivariate logistic regression were performed to identify risk factors and evaluate diagnostic value using ROC curve analysis.
Results: Infants with moderate to severe BPD had lower 1-minute Apgar scores, prolonged mechanical ventilation, and higher prevalence of maternal smoking and intrauterine infection (all P< 0.05). CD40L and NGAL levels were significantly higher in BPD infants (P< 0.001). Pearson analysis showed a strong positive correlation between CD40L and NGAL (r=0.800, P< 0.001). Multivariate logistic regression identified maternal smoking (OR=1.092, 95% CI: 1.030– 1.158), intrauterine infection (OR=1.136, 95% CI: 1.027– 1.256), elevated CD40L (OR=1.138, 95% CI: 1.042– 1.242), and NGAL (OR=1.270, 95% CI: 1.063– 1.518) as independent risk factors for BPD. ROC analysis confirmed the diagnostic utility of CD40L and NGAL, with combined assessment showing superior predictive performance.
Conclusion: Elevated levels of CD40L and NGAL in umbilical cord blood of preterm infants with moderate to severe BPD suggest that these biomarkers have high diagnostic value for moderate to severe BPD.
Keywords: bronchopulmonary dysplasia, preterm infants, umbilical cord blood, CD40L, NGAL, clinical value
1Department of Neonatology, Baoding Maternal and Child Health Care Hospital, Baoding, Hebei, People’s Republic of China; 2Department of Pediatrics, Baoding Maternal and Child Health Care Hospital, Baoding, Hebei, People’s Republic of China
Correspondence: Xuemin Qie, Department of Neonatology, Baoding Maternal and Child Health Care Hospital, Baoding, Hebei, People’s Republic of China, Email QieXueminxx88@163.com
Objective: To examine the concentrations of cluster of differentiation CD40 ligand (CD40L) and neutrophil gelatinase-associated lipocalin (NGAL) in preterm infants with moderate to severe bronchopulmonary dysplasia (BPD), as well as to elucidate their clinical implications.
Methods: A cohort of 138 preterm infants admitted to the neonatal intensive care unit between January 2021 and October 2022 were enrolled and divided into two groups: moderate to severe BPD (n=14) and non-BPD controls (n=124). Clinical data were collected. CD40L and NGAL levels in umbilical cord blood were measured by ELISA. Pearson correlation analysis and multivariate logistic regression were performed to identify risk factors and evaluate diagnostic value using ROC curve analysis.
Results: Infants with moderate to severe BPD had lower 1-minute Apgar scores, prolonged mechanical ventilation, and higher prevalence of maternal smoking and intrauterine infection (all P< 0.05). CD40L and NGAL levels were significantly higher in BPD infants (P< 0.001). Pearson analysis showed a strong positive correlation between CD40L and NGAL (r=0.800, P< 0.001). Multivariate logistic regression identified maternal smoking (OR=1.092, 95% CI: 1.030– 1.158), intrauterine infection (OR=1.136, 95% CI: 1.027– 1.256), elevated CD40L (OR=1.138, 95% CI: 1.042– 1.242), and NGAL (OR=1.270, 95% CI: 1.063– 1.518) as independent risk factors for BPD. ROC analysis confirmed the diagnostic utility of CD40L and NGAL, with combined assessment showing superior predictive performance.
Conclusion: Elevated levels of CD40L and NGAL in umbilical cord blood of preterm infants with moderate to severe BPD suggest that these biomarkers have high diagnostic value for moderate to severe BPD.
Keywords: bronchopulmonary dysplasia, preterm infants, umbilical cord blood, CD40L, NGAL, clinical value